Individual
MR. MARK F COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5629 HWY. 21 SOUTH, RINCON, GA 31326
(912) 295-2133
(912) 295-5924
Mailing address
5629 HWY. 21 SOUTH, RINCON, GA 31326
(912) 295-2133
(912) 295-5924
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
051450
GA
207P00000X
Emergency Medicine Physician
27447
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000948813A
—
GA
05
—
000948813B
—
GA
05
—
000948813D
—
GA
05
—
000948813F
—
SC
05
—
0100948813C
—
GA
01
—
10058598
AMERIGROUP
GA
05
—
G51450
—
SC
Enumeration date
06/07/2006
Last updated
05/15/2024
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